泌尿器科領域における膣トリコモナス症の研究

抄録

Many aspects of the host-parasite relationship of Trichomonas vaginalis still remain either unanswered, or poorly understood. The following studies, involving clinical evaluation, cultivation on artifical media, and animal inoculation procedures, were designed to provide a fundamental knowledge of the complexities of the relationship of T. vaginalis. with both human and animal hosts.
A selected group of 946 patients who visited the Urological Clinic of the Keio University Hospital with Symptoms of urinary infection such as unpleasant feeling, itching, pain and discharge were examined for T. vaginalis. A total of 1067 specimens were obtained from these patients, and cultured on a variety of artifical media. T. vaginalis so isolated were inoculated into a large series of surgieally altered, hormon-trerted, male albino rats.
1) On the 946 patients, 67 were infected with T. vaginalis. Of the patients suffering from a prostatic discharge 9 percent were found to be infected. Other symptoms and materials which were related to a positive diagnosis are listed with their respective precentages. Urethral discharge 8.9 percent; semen, 5.3 percent; urin, 4.6 percent and smegma 2.4 percent.
2) The symptoms which complained all 67 infected were not only particular as urinary infections but in 16 cases were complained nothing. The problems of symptomlos infection of T. vaginalis in male urinary tract will become more important on treatment in comming future.
3) Specimens from the 67 infected patients, in contrast to those from the non-infected patients, were all relatively acidic, ranging from PH 5.6 to 7.8
4) Of the 67 patients with T. vaginalis, 57 patients (70 percent) were positive for various other microorganisms such as Escherichia coli, Staphylococcus albus, and Pseudomonas. However, no paticular relationship between these organisms and T. vaginalis was noted.
5) Among the 67 infected cases, 62 (91 percent) gave a history involving sexual intercourse, with some 47 cases (76 percent) having wives who had complained of trichomoniasis previously, In a group of married women suffering from “honeymoon cystitis”, 17 percent were found infected, as compared to a series of unmarried women with an infection rate of only 3.6 percent. From these data, it appears evident that trichomoniasis is a venereal disease, with the majar source of infection being sexual partners.
6) T. vaginalis was inoculated into the urethra and forskin of human males. The parasite was found to survive for 3 days in the urethra and 7 days under the foreskin, but without any signs of multiplication.
7) Various concentrations of saline extracts of human prostate and smegma were added to a standard culture medium of cystein-bouillon-serum, and their effects on the growth of T. vaginalis studied. It was noted that the trichomonad did not grow better in the extractenriched media than in the control medium, and that in media composed of prostate or smegma extract alone, the organism failed to grow at all.
8) T. vaginalis serially maintained in cystein-bouillon-serum medium without a ccompanying bacteria were inoculated into muscle urethra, bladder, and seminal vesicle, of normal male albino rats; castrated male rats; and castrated, androgen-treated male rats.
A) In muscle, T. vaginalis did not multiply, and disappeared in several days.
B) In the bladder, of 4 cases, out of 14 control or castrated, and or androgen-treated rats could lived for 10 days long, but did not multiply any more.
C) In the seminal vesicle of either normal or castrated rats, the inoculated T. vaginalis persisted for only 5 to 6 days. In the castrated, androgen-treated group of rats however, the parasite was able to multiply and survive for more than 2 weeks.
9) The fact that T. vaginalis was able to live and multiply only in the seminal vesicle of the androgen-treated male castrated is believed dur to one of the metabolic effects of the androgens in males